Abstract
Antimicrobial resistance has emerged as a global health threat. Antimicrobial resistant Escherichia coli infections are associated with high morbidity and expenditure when compared with infections caused by susceptible strains. In Nigeria, antimicrobial drugs are readily available over-the-counter with potential for indiscriminate use by poultry farmers and eventual development of drug resistance. The objective of this study was to investigate prevalence and risk factors for multi-drug resistant E. coli among poultry workers (PW) in Abuja, Nigeria. A cross-sectional study was conducted among 122 randomly selected apparently healthy poultry workers (poultry-farmers/ sellers) in Municipal and Kuje Area Councils from December 2018 to April 2019. Data was collected on socio-demographics and exposure factors using a structured interviewer-administered questionnaire. E. coli was isolated and identified from stool samples of poultry workers. Antibiotic susceptibility testing was done using Kirby-Bauer disk diffusion method. Multidrug resistance (MDR) was defined as resistance to three or more classes of antimicrobials. Data was analyzed by computing proportions, prevalence odds-ratios (POR) and logistic regression at 5% significance level. Among PW, there were 121 males (99.2%). Mean age of the male workers was 30.6 ± 9.7years, 54.6% (n = 66) married, 57.9% (n = 70) had secondary education and 62.0% (n = 75) were farm-workers. Prevalence of E. coli was 39.7% (n = 48), highest among farm-workers (POR = 2.7, 95% Confidence Interval [CI] = 1.3-5.7; p = 0.01) compared to poultry-sellers. Of the 48 E. coli isolates, 16.7% (n = 8) were extended spectrum beta lactamase (ESBL) producers and 79.2% (n = 38) were MDR. We detected resistance against Tetracycline: (83.3%, n = 40), Sulfamethoxazole-Trimethoprim: (79.2%, n = 38), Ampicillin: (77.1%, n = 37), Streptomycin: (72.9%, n = 35), Nalidixic acid: (50%, n = 24), Gentamicin: (41.7%, n = 20), Chloramphenicol: (31.3%, n = 15), Cephalothin: (27.1%, n = 13), Nitrofurantoin: (10.4%, n = 5) and Imipenem: (6.3%, n = 3). Absence of lavatory (POR = 2.7, 95% CI = 1.1-6.7); existence of farm/market for >10years (POR = 2.5, 95% CI = 1.1-5.4) and PW's history of diarrhea in last three months (POR = 2.8, CI = 1.2-6.3) were associated with MDR. Controlling for age, absence of lavatory (adjusted OR [aOR] = 4.31, 95% CI = 1.6-11.9); PW's history of diarrhea in last three months (aOR = 3.3,95%CI = 1.3-8.5) and work exposure >10years (aOR = 0.3, 95%CI = 0.1-0.9) remained independent risk factors for MDR. Prevalence of resistant E. coli was highest among farm-workers and associated with older farms/markets, occupational exposure of over 10 years and poor hygienic measures. The management of Municipal and Kuje Area Councils were recommended to provide lavatories for public use in farm-settlements/markets. The importance of hand-hygiene and responsible use of antimicrobials in poultry production was emphasized.
Highlights
Escherichia coli is an important cause of food borne illness and a public health threat, especially in sub-Saharan Africa including Nigeria [1]
This study focused on the prevalence of multi-drug resistant E. coli in humans working on poultry farms and live bird markets (LBM)
The objective of this study was to determine the prevalence and risk factors for Multidrug resistance (MDR) E. coli among poultry workers in the Federal Capital Territory (FCT), Abuja Nigeria to generate baseline data for the implementation of the National Action Plan on Antimicrobial resistance (AMR) in Nigeria
Summary
Escherichia coli is an important cause of food borne illness and a public health threat, especially in sub-Saharan Africa including Nigeria [1]. The increasing occurrence of drug-resistant E. coli isolates of human and animal origin is a global public health problem. Antibiotic resistant E. coli infections are presently associated with higher morbidity, mortality, and invariably higher expenditure in treatment compared with infections by strains susceptible to the drugs. Drug resistant commensal E. coli, which may not directly cause disease, remains significant in public health as a reservoir of drug resistance genes. These genes can be transferred to humans and zoonotic pathogens, such as E. coli, Salmonella, or to other gram-negative bacteria in the gut [3,4]. Antimicrobial resistant Escherichia coli infections are associated with high morbidity and expenditure when compared with infections caused by susceptible strains. The objective of this study was to investigate prevalence and risk factors for multi-drug resistant E. coli among poultry workers (PW) in Abuja, Nigeria
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